缺血性脑卒中患者个性化超早期康复护理自我体验的质性研究

Self-Experience of Personalized Very Early Rehabilitation Nursing for Patients with Ischemic Stroke: A Qualitative Study

摘要: 目的：了解缺血性脑卒中患者进行个性化超早期康复护理后的真实自我体验，为临床开展缺血性脑卒中患者超早期康复干预提供科学依据，促进患者的康复。方法：选取2020年11月~2021年2月在某三级甲等医院神经内科住院进行个性化超早期康复护理的缺血性脑卒中患者8名作为研究对象，采用面对面的半结构式深入访谈，运用Colaizzi现象学资料7步分析法对访谈资料进行分析归纳。结果：缺血性脑卒中患者进行个性化超早期康复护理的自我体验可归纳为3个主题：① 缺血性脑卒中患者患病后的负性体验包括：恐惧、焦虑、悲伤、痛苦、自责、自尊心低下等；② 患者在进行个性化超早期康复时的体验有：心情愉悦、身体舒适以及自信心增强等；③ 个性化超早期康复护理后负性体验逐渐被积极体验代替：肢体功能改善、负性情绪减弱、自我康复能力提高、依从性增加等。结论：缺血性脑卒中患者在患病后有不同程度的负性体验，医护人员、家庭和社会应关注并重视患者的需求，给予个性化的支持。超早期康复护理有利于改善患者肢体功能障碍，提高患者的生活质量，值得在临床上推广。

Abstract: Objective: To explore the real experiences of very early rehabilitation nursing for patients with ischemic stroke, in order to provide reference and develop targeted interventions to improve patients’ mental state. Methods: Using face-to-face, semi-structured indepth interviews, 8 ischemic stroke patients who visited the Department of Neurology of a Grade III, Grade A hospital in Shiyan from November 2020 to February 2021 were selected as subjects. The interview content was analyzed by Colaizzi’s 7-step method. Results: Three themes emerged as the psychological experience of patients with ischemic stroke during very early rehabilitation nursing: ① The negative experiences of patients with ischemic stroke include fear, anxiety, sadness, pain, self-accusation, low self-esteem, etc. ② The experience of patients in individualized very early rehabilitation includes: cheerful mood, physical comfort and increased self-confidence, etc. ③ After individualized very early rehabilitation, the negative experience is gradually replaced by the positive experience: the improvement of limb function, the weakening of negative emotion, the improvement of self-rehabilitation ability, and the increase of compliance. Conclusion: Patients with ischemic stroke suffer from varying degrees of negative experience after the disease. Attention should be paid to the patients by medical staff, family and society to give personalized support. Very early rehabilitation is beneficial to the improvement of limb dysfunction and the improvement of patients’ quality of life, which is worthy of clinical promotion.